Importance of Proprioceptive Information for Postural Control in Children with Strabismus before and after Strabismus Surgery.

Maria P Bucci,Lucile Colleville,Hayette Soufi,Philippe Villeneuve,Cynthia Lions,Emmanuel Bui-Quoc

doi:10.3389/fnsys.2016.00067

Abstract

The objective of this study is to examine the role of proprioception in postural balance in children with strabismus before and after realignment of their visual axes by eye surgery. Postural recordings were made with the TechnoConcept® force platform in 23 children. Several conditions were studied, whether the subjects had both eyes open, or either the dominant or the non-dominant eye open, without and with foam pads of 4 mm underfoot. Recordings were performed before and after strabismus surgery. The surface area, the length and the mean speed of the center of pressure (CoP) were analyzed. Before strabismus surgery, all children showed better stability with both eyes open with respect to the condition with the non-dominant eye open; furthermore postural stability improved in the presence of foam pads. After surgery, the surface area of CoP decreased significantly, especially in the non-dominant eye viewing condition. We suggest that strabismic children use mainly proprioceptive information in order to control their posture, but also visual inputs, which are important for obtaining a good postural stability. The alignment of the visual axes after surgery provides enhanced postural stability, suggesting, again the major role of visual inputs in the control of posture. Proprioceptive plasticity after strabismus surgery may allow better visual rehabilitation.

Highlights

Strabismus occurs in about 2% of children
The main findings of this study are as follows: (i) Before strabismus surgery, strabismic children showed better stability with both eyes open with respect to the condition when the non-dominant eye is open; (ii) Postural stability improved in the presence of foam pads; (iii) After surgery, postural control improved significantly
We reported that all postural parameters examined decreased significantly when children were on a 4 mm foam pad suggesting that such fine foam pad is able to improve proprioception activity in strabismic children leading to better postural control

Summary

Introduction

Strabismus occurs in about 2% of children. The visual capabilities of strabismic children depends on the age of its apparition and depends on the type of strabismus. A key factor in the diagnosis and treatment of strabismus is binocular vision, whether it is normal or abnormal and whether it is possible or not to restore it, depending on whether the strabismus occurs early or late. Early onset strabismus, which occurs within the first 2 years of life does not allow the establishment of binocular vision, and stereoscopic vision. If strabismus occurs later in life, a normal development of binocular vision is possible. Strabismus surgery is often necessary to obtain ocular realignment, which is compulsory to restore stereoscopy and a better visual perception (von Noorden and Campos, 2006)

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